An interventional study of Scenario-Based Fact-Checking Course and Nutrition Education in eHealth Literacy, Digital Health Literacy and Fact Checking, sponsored by National Yang Ming Chiao Tung University. Not yet recruiting. Open to participants aged 65 Years to 100 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-10-21.
Sponsored by National Yang Ming Chiao Tung University · Not applicable, Interventional, and Other
As more older adults use the internet to seek health information, it may be difficult to determine whether online information is trustworthy. Social media posts, advertisements, messages, and product promotions may contain misleading information or scams. This study will examine whether a practical fact-checking course can help older adults make more accurate judgments about online health information.
Approximately 100 older adults from senior learning centers in northern Taiwan will participate in this study. Participants will be assigned to one of two groups. The experimental group will receive a four-week health information fact-checking course, and the control group will receive a four-week nutrition education course. Both groups will participate in learning activities; however, only the fact-checking course will involve digital tools and examples of online health information.
Participants in the fact-checking course will practice evaluating health information through common real-life situations, including health-related social media posts, online product advertisements, free-gift promotions, and suspicious text messages. The course will teach a fact-checking method called SIFT:
Stop: Pause before believing or sharing information. Investigate the source: Check who created or posted the information. Find better coverage: Look for other reliable sources that discuss the same claim.
Trace claims to the original context: Locate the original source and determine whether the claim has been presented accurately.
Before and after the four-week intervention, participants will complete questionnaires and short activities concerning the use of online health information and the evaluation of health-related messages. The investigators will compare outcomes between the two groups to determine whether the fact-checking course improves confidence and accuracy in judging online health information.
This study may inform the development of digital health learning programs for older adults.
Background and Rationale Taiwan has entered a super-aged society, and older adults increasingly use the internet to obtain health information. At the same time, older adults may face digital divides, misinformation, and health fraud risks. Existing digital learning programs for older adults often emphasize device operation and creative digital products, with relatively limited attention to evaluating information sources and verifying claims. As a result, available programs may not adequately address practical needs related to judging the trustworthiness of online health information.
Purpose This study aims to develop and evaluate a scenario-based fact-checking course focused on online health information. The intervention will integrate theoretical instruction and practical learning activities. Its effectiveness will be evaluated using the eHealth Literacy Scale (eHEALS), the Digital Health Literacy Instrument (DHLI), SIFT strategy implementation, and health information judgment accuracy within a quasi-experimental design.
Methods This quasi-experimental study will recruit approximately 100 older adults from six senior learning centers in northern Taiwan. Participants will be assigned to either an experimental group or a control group. Both groups will complete baseline and post-intervention assessments, including a demographic questionnaire, the eHealth Literacy Scale (eHEALS), the Digital Health Literacy Instrument (DHLI), and a health information judgment test.
During the four-week intervention, participants in the experimental group will receive a scenario-based health information fact-checking course. The course will teach the SIFT strategy: Stop, Investigate the source, Find better coverage, and Trace claims to the original context. Participants will complete worksheets documenting SIFT strategy implementation and the accuracy of health information judgments.
The course will incorporate four authentic or simulated health information scenarios commonly encountered by older adults: medical posts claiming endorsement by authorities, health product advertisements promoted through influencer live streams, suspicious free-gift promotions, and potentially fraudulent subsidy text messages assessed through website URL examination. These scenarios are designed to support hands-on practice in lateral reading, source evaluation, and fact-checking.
Participants in the control group will receive a four-week nutrition education program without digital technologies, online health information evaluation, or digital learning materials. Analysis of covariance (ANCOVA) will be used to examine between-group differences in post-intervention eHealth literacy, digital health literacy, and health information judgment outcomes while controlling for baseline measures.
Expected Results After controlling for baseline differences and participant characteristics, the experimental group is expected to demonstrate higher overall eHEALS scores, DHLI domain scores, and health information judgment accuracy than the control group. SIFT strategy implementation is also expected to increase progressively during the four-week intervention, indicating that older adults can apply fact-checking strategies in authentic online health information contexts.
National Yang Ming Chiao Tung University is the lead sponsor of 204 studies on the registry; 58 are open to participants now.
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Participants will receive a four-week scenario-based health information fact-checking course.
Behavioral: Scenario-Based Fact-Checking Course
Participants will receive a four-week nutrition education program.
Behavioral: Nutrition Education
This four-week behavioral education intervention is a scenario-based fact-checking course designed to improve older adults' ability to evaluate online health information. The course teaches the SIFT strategy: Stop, Investigate the source, Find better coverage, and Trace claims to the original context. Participants will use digital devices and structured worksheets to practice checking the credibility and accuracy of health-related information. Learning activities are based on four common online scenarios: health-related social media posts claiming endorsement by authorities, influencer-promoted health product advertisements, suspicious free-gift promotions, and potentially fraudulent subsidy text messages. The course emphasizes lateral reading, source evaluation, and verification of health claims through hands-on practice.
This four-week behavioral nutrition education program is designed as an active comparison intervention. Participants will receive general education on healthy eating and nutrition for older adults, including balanced food choices, dietary habits, and basic nutrition principles. The program will be delivered without digital devices, online health information evaluation, or fact-checking instruction. Its duration and session schedule will be comparable to those of the experimental group.
eHealth Literacy
eHealth literacy will be assessed using the eHealth Literacy Scale (eHEALS), an 8-item self-report questionnaire that measures perceived ability to locate, understand, evaluate, and use online health information. Each item is rated on a 5-point Likert scale. Item scores will be summed to produce a total score ranging from 8 to 40. Higher scores indicate higher perceived eHealth literacy. The outcome will be assessed at baseline and immediately after the four-week intervention.
Time frame: Baseline and immediately after the 4-week intervention
Digital Health Literacy (DHLI)
Digital health literacy(DHLI) will be assessed using the 30-item Chinese version of the Digital Health Literacy Instrument. The instrument includes 23 self-report items and 7 objective performance-based items. Self-report items assess perceived digital health literacy using a 4-point Likert scale. Task-difficulty items range from 1, very easy, to 4, very difficult; frequency-of-difficulty items range from 1, never, to 4, often. Self-report items will be reverse-coded. Total self-report scores range from 23 to 92, with higher scores indicating better perceived digital health literacy. Objective items are scored as correct (1) or incorrect (0), with total scores ranging from 0 to 7; higher scores indicate better performance. Assessments will occur at baseline and immediately after the 4-week intervention.
Time frame: Baseline and immediately after the 4-week intervention
Health Information Judgment Accuracy
Health information judgment accuracy will be assessed using the Researcher Developed Scenario Based Health Information Judgment Test. The test includes four health information scenarios at baseline and four comparable scenarios after the intervention. Each scenario is scored as correct (1) or incorrect (0). Total scores range from 0 to 4, with higher scores indicating greater accuracy in judging the credibility or accuracy of online health information. The outcome will be assessed at baseline and immediately after the four-week intervention.
Time frame: Baseline and immediately after the 4-week intervention
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Plan to share: No — Data access will be limited to authorized members of the research team, including the principal investigator, for research oversight, data management, and analysis in accordance with the approved ethical protocol and informed consent procedures.
Start is estimated for Sep 2026; primary completion for Dec 2026, 3 months later.
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